title: Lack of association of herpes simplex virus type 2 seropositivity with the progression of HIV infection in the HERS cohort.
abstract: Many studies have chronicled the "epidemiologic synergy" between human immunodeficiency virus (HIV) and herpes simplex virus type 2 (HSV-2). HIV adversely affects the natural history of HSV-2 and results in more frequent and severe HSV-2 reactivation. Few longitudinal studies, however, have examined whether HSV-2 is associated with increased HIV plasma viral loads or decreased CD4 counts. The authors estimated the effect of HSV-2 seropositivity on HIV RNA viral load and on CD4 count over time among 777 HIV-seropositive US women not receiving suppressive HSV-2 therapy in the HIV Epidemiology Research Study (1993-2000). Linear mixed models were used to assess the effect of HSV-2 on log HIV viral load and CD4 count/mm(3) prior to widespread initiation of highly active antiretroviral therapy. Coinfection with HSV-2 was not associated with HIV RNA plasma viral loads during study follow-up. There was a statistically significant association between HSV-2 seropositivity and CD4 count over time, but this difference was small and counterintuitive at an increase of 8 cells/mm(3) (95% confidence interval: 2, 14) per year among HSV-2-seropositive women compared with HSV-2-seronegative women. These data do not support a clinically meaningful effect of baseline HSV-2 seropositivity on the trajectories of HIV plasma viral loads or CD4 counts.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC 27599-7435, USA.
authors.forename: Brooke E
authors.initials: BE
authors.lastname: Hoots
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hudgens
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.forename: Caroline C
authors.initials: CC
authors.lastname: King
authors.forename: Robert S
authors.initials: RS
authors.lastname: Klein
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Anne M
authors.initials: AM
authors.lastname: Rompalo
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
mesh_terms: D000328:Adult; D015153:Blotting, Western; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D006558:Herpes Genitalis / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D018258:Herpesvirus 2, Human; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D015995:Prevalence; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D018709:Statistics, Nonparametric; D014481:United States / Q000453:epidemiology; D019562:Viral Load